How to Strengthen & Relax Your Pelvic Floor

When we refer to the “pelvic floor”, we’re referring to the muscles that support your pelvic organs. Out of all the muscles on a woman, the pelvic floor plays one of the most vital roles in overall health, supporting essential organs, maintaining bladder and bowel control, and contributing to core stability.

Like many other muscles, the pelvic floor muscles need care and attention to function properly. Pelvic floor massage is a common treatment for pelvic floor dysfunction. It is a key part of pelvic floor physical therapy. The concept of pelvic floor massage is to re-train the muscles, restore strength in weakened areas and reduce discomfort in areas that are painful to touch. With one in three women experiencing pelvic floor dysfunction at some point in their lifetime, pelvic floor massage can be one way to treat these symptoms and improve overall pelvic floor health.

Like all muscles, over time they can lose their strength and tone if they are not exercised, and the pelvic floor is no different. As women age or go through pregnancy and labour, the pelvic floor can change quite dramatically, however, if you regularly do pelvic floor exercises, your pelvic floor health will be in a much better position to handle the changes that come your way.

Understanding the Pelvic Floor

The pelvic floor is a group of muscles located between the coccyx and pubic bone, supporting key organs such as the bladder, uterus, vagina, and bowel. These muscles contract and relax as needed, playing a crucial role in bladder and bowel control, sexual function, and overall core stability.

Factors like pregnancy, ageing, and hormonal changes can affect pelvic floor health, leading to pelvic floor dysfunction (PFD). In a survey of 2000 women, over half of the women had experienced pelvic floor dysfunction symptoms and 39% of them thought these symptoms were normal. Despite its prevalence, PFD is often misunderstood.

Common Symptoms of Pelvic Floor Dysfunction:

• Urinary incontinence

• Faecal incontinence

• Painful intercourse

• Lower back pain

• Constipation

• Pelvic organ prolapse

Recognizing these symptoms early is essential. A pelvic floor specialist can create a tailored treatment plan that may include pelvic floor therapy, targeted exercises, or the use of a pelvic floor exerciser like the Elvie Pelvic Floor Trainer or Kegel weights such as the Bodyotics Kegel Balls to help restore strength and function.

How to Tell If Your Pelvic Floor Is Tight or Weak

Not all pelvic floor issues stem from weakness—sometimes, a hypertonic pelvic floor (excessively tight muscles) can be the problem. This can cause difficulty relaxing, pain during intercourse, constipation, and urinary urgency. Conversely, a weak pelvic floor may result in urine leakage when coughing or exercising, lower back pain, or a sensation of heaviness in the pelvis.

If you're unsure whether your pelvic floor is too tight or too weak, consulting a pelvic floor therapist can help determine the best course of action. Proper diagnosis is key to choosing the right exercises or treatments to restore balance and improve function.

How Pelvic Floor Massage Supports Pelvic Floor Therapy

Pelvic floor physical therapy focuses on more than just the muscles—it also treats bones, ligaments, and connective tissues for overall pelvic health. The treatments that make up this type of therapy, such as pelvic floor massage, are aimed at improving overall pelvic floor health and reducing the severity of pelvic floor dysfunction symptoms.

Pelvic floor massage is an effective therapy, even though some may feel hesitant about trying it. Not all exercises require internal massage, as some of these are done externally. Pelvic floor massage can help to stretch and improve the mobility of the muscles, so they learn to relax rather than contract, which in turn improves urinary and faecal functions in the bladder and bowel. Imagine sneezing without having to cross your legs first!

Some people experience chronic pain in their pelvis and pelvic floor region which can affect one's quality of life and ease of doing everyday activities. Simple pelvic floor massage techniques can reduce pain points and re-associate parts of the pelvic floor that were once painful into a more positive feeling. This is called sensory integration.

Want to reduce pelvic pain? Read our guide on pelvic pain relief during pregnancy

For women who are in the postpartum phase after giving birth, their body and pelvic floor will take time to recover and for most first-time mothers, noticeable improvements can be seen a year after the birth. A support band like Lola & Lykke’s Postpartum Support Band helps new mothers recover by supporting the core and pelvic floor. It also helps to alleviate any pressure in your lower back by correcting your posture and engaging your core muscles whilst your body is still recovering from the birth, which in turn positively affects your pelvic floor and aiding the recovery there too.

How do I know if I need a pelvic floor massage?

Normally, people turn to pelvic floor specialists when they experience symptoms of pelvic floor dysfunction and it’s affecting their ability to carry out everyday activities. Here are some, but not limited to, pelvic floor dysfunction symptoms that may lead to a specialist advising pelvic floor massage as a way forward to specifically treat certain areas of your pelvic floor.

• Painful urination

• Urinary or faecal incontinence

• Constipation

• Pelvic pain

• Pelvic muscle spasms

• Vaginismus (involuntary pelvic floor muscles contracting and spasming during vaginal penetration)

• Tailbone pain

• Pelvic organ prolapse

• Postpartum issues

• Chronic pain near the vagina (Vulvodynia)

• Bladder pain

Some lesser-known signs of pelvic floor dysfunction include frequent or urgent urination. You can also feel pain in your lower back which might seem unrelated, but it can be a hidden sign of pelvic floor issues.

Some lifestyle factors can affect the performance of your pelvic floor and if you engage in any of these for a long or consistent period of time, you may want to consider getting a pelvic floor check-up to assess the overall health of your pelvic floor.

• High-impact exercises such as running and rebound classes can weaken your pelvic floor over time because of the pressure it endures during these workouts.

• Sitting for long periods of time can compress your pelvic organs and put additional pressure on your core and pelvic floor muscles.

• As you progress through pregnancy, your growing baby will apply pressure to your pelvic organs as it gets bigger and needs more room! The process of labour can also cause pelvic floor muscles to weaken as they are stretched, and sometimes torn, during birth.

Learn more: Lola&Lykke Experts Explain the Importance of a Pelvic Floor Check-Up—What It Is and Why It Matters!

How to Perform Pelvic Floor Massage

You are not alone in thinking, “Is this muscle pelvic floor? Where is it? I can feel something but is that it?”. A lot of women, even those attending pelvic floor exercise classes, are sometimes unsure of what they should feel when exercising or massaging the pelvic floor. So in case you’re wondering how you can learn to do this, here is a simple step-by-step guide on how to perform a pelvic floor massage.

• Get yourself comfortable with blankets and pillows for support. You want to feel relaxed, so set up the space so it allows you to feel calm - it’s no different than if you were going to a spa for a massage!

• Lie on your back or side in a comfortable position, using pillows for support. Ensure you can easily reach the vaginal area without straining.

• Start by breathing in so your tummy expands and breathing out slowly through your nose. This will naturally relax your pelvic floor. Continue doing this until you are ready to insert your index finger and thumb as you exhale.

• Insert your index finger and thumb into your vagina and move your finger down the sides of the pelvic muscles with gentle pressure applied. (Avoid touching the urethra and rectum).

• The aim is to “map” out your pelvic muscles with touch and learn where you feel any pain, if at all. Through touch, you can increase the connectivity with your pelvic muscles.

• You can try adding deeper pressure as you explore further to the sides of the vagina. As you notice trigger points or areas which are more tender, move your finger in small circular motions to help relieve any tension.

• Notice how your body responds to touch in certain areas and only do what feels good. If the massage starts to feel painful at any point, try reducing the pressure or doing lighter massage strokes.

• If you find an area that is more tender, slow your breathing down and use gentle massage strokes, as long as this is comfortable to continue.

If you’re not sure how to locate your pelvic floor muscles, this short video explains where the muscles sit and how you can learn to feel them:

For further information about how to perform pelvic floor massage, ask one of our pelvic floor physiotherapists on our Experts Panel.

Pelvic Floor Massage Tools and Techniques

To support your pelvic floor massage, there are different tools that you can use to assist you. Pelvic floor physiotherapy professionals often recommend tools such as pelvic wands, vaginal or rectal dilators, and lubrication. The tool you choose to use will depend on what your diagnosis and symptoms are so you can access those trigger points.

Pelvic floor massage tools can help you target specific muscles. Options include:

• Pelvic wands (for internal muscle release)

• Biofeedback devices (to measure muscle activity)

• Massage therapy balls (for external tension relief)

Pelvic Floor Massage Techniques

• Myofascial Release: This technique involves sustained pressure on the myofascial connective tissue to release muscular tightness and improve flexibility. Myofascial release can be applied externally or internally with the use of tools.

• Trigger Point Therapy: Focused pressure is applied to areas of tight pelvic floor muscles to alleviate pain and tension.

• Stretching and Pelvic Floor Relaxation Exercises: Try gentle stretching, such as moving your knees side to side or sitting in yoga poses, which can help you to feel relaxed and reduce overall tension.

• Breathing Techniques: Mindful breathing during pelvic floor massage helps you to relax the muscles and release tension. It can also help you to focus on the massage giving you a deeper connection to what you can feel.

• Warm-Up and Cool-Down: Just like any other form of exercise, pelvic floor massage benefits from a proper warm-up and cool-down. Gentle warm-up exercises and gradual introduction of pressure prepare the muscles for massage, while a cool-down helps prevent any post-massage discomfort.

Exercises and Stretches for Pelvic Floor Health

Pelvic floor exercises have been proven to improve pelvic floor health and reduce the severity of pelvic floor dysfunction symptoms. The exercises can be done anywhere, anytime and it’s even better if you can start to incorporate these into your daily routine for consistency. Repeating these exercises over time, when you’re doing them properly, will give you noticeable results. Some people start to notice a change after 3 months of consistently performing pelvic floor exercises. You can also use a pelvic floor trainer to enhance your workout.

Pelvic Floor Exercises to Try

Before starting any exercises, it’s a good idea to empty your bladder so you can fully relax and engage in the exercises. Make sure you are sitting or lying comfortably and you have a Kegel weight handy if you want to incorporate this into your routine.

• Tighten your pelvic floor muscles for a count of ten.

• Relax the muscles for a count of ten.

• Try breathing in as you relax your pelvic floor and tighten as you breathe out.

• Repeat this up to ten times, up to three times per day.

Kegel exercises are effective to do alongside pelvic floor massage to improve your results and overall pelvic floor health. The Bodyotics Deluxe Kegel Weighted Exercise Balls have varying sizes and weights, so you start with the lightest Kegel weight and work your way up to the heavier Kegel weight. Explore valuable guidance and tips on Kegel exercises in the Complete Guide to Kegel Exercise for comprehensive insights into optimizing your pelvic floor health.

It’s important to note that before you start to do any pelvic floor exercises, you must seek advice from your doctor or a pelvic floor specialist so that they can suggest the correct treatment plan for your symptoms. For example, if you have a hypertonic pelvic floor, you may be advised to reduce or stop doing exercises such as squats, crunches, or planks to prevent further strain on your pelvic muscles.

Low-Impact Stretches for Tight Pelvic Floor

Especially if you have a tight pelvic floor, low-impact stretches such as Yoga poses can help you improve mobility whilst managing your pelvic floor symptoms. By doing exercises like this, you can still work out and keep active without doing any high-impact exercises.

Tight Pelvic Floor Stretches and Yoga Poses

When choosing stretches and routines to follow, you want to avoid doing anything that puts a strain on your pelvic floor muscles. Doing so will only cause further strain and damage to this muscle group.

Stretches to Strengthen the Pelvic Floor

Kegel weights and Kegel ball exercises are an effective way to strengthen the pelvic floor muscles. We can use weights to strengthen other muscles in our body, so why not your pelvic floor? You can do Kegel exercises sitting, laying, or standing up, however, if your pelvic floor is weak, you should start the exercises laying down.

Try this Kegel exercise routine to get used to how they feel and to know if you are doing them properly.

Ask for Support

When it comes to managing your pelvic floor health, you need to take a comprehensive approach. Seeking support from a healthcare professional to diagnose symptoms early on, and start a treatment plan including pelvic floor massage and exercises, will mean that you can start to reap the benefits of improved pelvic floor health.